Long-term effects of different exercise training modes on cytokines and adipokines in individuals with overweight/obesity and cardiometabolic diseases: A systematic review, meta-analysis, and meta-regression of randomized controlled trials

The present study aimed to investigate the evidence on the effects of different long-term training interventions (aerobic [AeT], resistance [RT], and combined [COMB]) and spontaneous physical activity (PA) in modifying cytokines and adipokines in individuals with overweight or obesity with or without cardiometabolic diseases while considering potential confounders. Although exercise interventions have become a potentially effective tool for preventing and treating metabolic diseases, the evidence provided by previous systematic reviews is inconclusive since several potential confounders have yet to be addressed. Therefore, we conducted a systematic literature search in Medline, Cochrane, and Embase databases from January 2000 to July 2022 and performed a meta-analysis. Inclusion criteria retrieved 106 full texts comprising 8,642 individuals with a range BMI of 25.1-43.8 kg m(-2). We found that independently of the training mode, exercise had a beneficial effect on diminishing Adiponectin, C-reactive protein (CRP), IL-6, IL-18, IL-20, Leptin, sICAM, and TNF-a levels circulating levels. Furthermore, by subsequent analysis, we detected differential effects of AeT, RT, and COMB, with sex, age, body composition, and trial length acting as moderators. The comparison of training modes revealed a difference favoring COMB over AeT for regulating the increase in CRP with no differences in the remaining biomarkers. Meta-regression analysis revealed an effect of change in maximal oxygen uptake (VO2max) on CRP, IL-6, and TNF-a, while IL-10 was influenced by the change in body fat. The results suggest that all interventions, except PA, are effective in lessening this population's inflammatory status, provided that exercise results in an increase of VO2max.